Objective To assess the effects of physiotherapy on pulmonary function in COPD patients with lung cancer after lobectomy or pneumonectomy. Methods Fifty-five COPD patients with lung cancer undergoing lobectomy or pneumonectomy from January 2005 to May 2014 were recruited in the study. They were divided into group A received comprehensive physiotherapy before surgery and group B without comprehensive physiotherapy before surgery. The changes of lung function and tolerance were compared before physiotherapy (T1 time point) and after physiotherapy (T2 time point) in the group A, and between two groups before lung resection (T2 time point) and after lung resection (T3 time point). Results In group A, the forced expiratory volume in one second (FEV1), vital capacity (VC), peak expiratory flow at 50% of vital capacity (FEF50) and FEF25 increased significantly respectively by 16.96%, 14.75%, 20.69% and 13.79% compared with those before physiotherapy. Meanwhile, six-minutes walking distance (6MWD) achieved a significant improvement. After resection of lung, FEV1 and VC appeared to reduce, and pulmonary small airway function, tolerance, and clinical features deteriorated significantly. The differences between T2 and T1 in FEV1, FEF50 and FEF25 in the patients with FEV1%pred ≥80% and 50%-80% were similar with those in the patients with FEV1%pred<50%. The differences between T2 and T3 in FEF50 and FEF25 in the patients with FEV1%pred≥80% and 50%-80% were higher than those with FEV1%pred<50%. For the patients with lobectomy, FEV1 and VC in the group B were lower than those in the group A (FEV1: 10.24% vs. 22.44%; VC: 10.13% vs. 20.87%). For the patients with pulmonary resection, FEV1 and VC had little differences (FEV1: 36.33% vs. 36.78%; VC: 37.23% vs. 38.98%). Conclusion Physiotherapy is very important for the preoperative treatment and postoperative nursing of COPD patients with primary lung cancer.
Objective To investigate the expression and clinical value of long chain non-coding RNA nicotinamide nucleotide hydrogenase antisense RNA1 (LncRNA NNT-AS1), motor neuron and pancreas homeobox protein 1 antisense RNA1 (MNX1-AS1) in lung cancer patients. Methods This study selected 128 patients diagnosed with lung cancer admitted to The Third Medical Center of the General Hospital of the People’s Liberation Army from April 2020 to April 2021 as a cancer group. During the same period, 128 patients with benign pulmonary nodules were regarded as a benign group, and 128 healthy individuals who underwent physical examination were selected as a control group. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to detect the levels of LncRNA NNT-AS1 and MNX1-AS1 in serum. A three-year follow-up was conducted on all lung cancer patients, with 52 patients in the death group and 76 patients in the survival group. Receiver operator characteristic (ROC) curve was applied to analyze the diagnostic value of serum LncRNA NNT-AS1 and MNX1-AS1 for the occurrence of lung cancer and their predictive value for prognosis. Results Compared with the control group, the serum levels of LncRNA NNT-AS1 and MNX1-AS1 were obviously increased in the benign group and the cancer group (P<0.05). Compared with the benign group, the levels of LncRNA NNT-AS1 and MNX1-AS1 in serum of the cancer patients were obviously increased (P<0.05). The area under ROC curve (AUC) of serum LncRNA NNT-AS1 combined with MNX1-AS1 for the diagnosis of lung cancer was higher than that of LncRNA NNT-AS1 and MNX1-AS1 alone (ZLncRNA NNT-AS1~LncRNA NNT-AS1+MNX1-AS1=2.496, P=0.013; ZMNX1-AS1~LncRNA NNT-AS1+MNX1-AS1=2.831, P=0.007). The levels of LncRNA NNT-AS1 and MNX1-AS1 were related to tumor differentiation, clinical stage, and lymph node metastasis (P<0.05). Compared with the survival group, the serum levels of LncRNA NNT-AS1 and MNX1-AS1 in the death group were obviously increased (P<0.05). The AUC of combined prediction for lung cancer prognosis by serum LncRNA NNT-AS1 and MNX1-AS1 was higher than that predicted by LncRNA NNT-AS1 and MNX1-AS1 alone (ZLncRNA NNT-AS1~LncRNA NNT-AS1+MNX1-AS1=2.539, P=0.011; ZMNX1-AS1~LncRNA NNT-AS1+MNX1-AS1=3.377, P=0.001). Conclusion LncRNA NNT-AS1 and MNX1-AS1 are highly expressed in serum of lung cancer patients, and both have certain value in diagnosis and prognosis evaluation of lung cancer.
目的:探討電子支氣管鏡在肺癌診斷中的價值。方法:對233例支氣管鏡下診斷肺癌的患者進行分析。結果:電子支氣管鏡下肺癌的診斷率為63.49%,其中中央型肺癌的診斷率為72.85%,周圍型肺癌的診斷率為27.63%,該組病例以老年人多見, 腫瘤多位于葉支氣管,右肺57.51%, 左肺42.49%,病理類型為鱗癌45.92%, 小細胞癌22.75%, 腺癌24.03%。電子支氣管鏡下主要特征:鱗癌以管內增殖型改變為主,表現為新生物形成,阻塞管腔,伴有糜爛、充血、水腫,小細胞癌以增殖型和浸潤型為主,可見氣管內新生物形成及節結樣改變。腺癌以管內增殖型和腫塊壓迫管腔為主,可見管內新生物形成或支氣管呈縫隙樣狹窄,甚至閉塞。結論:與周圍型肺癌相比電子支氣管鏡檢查對中心型肺癌診斷的準確率較高, 其檢查方法簡單, 創傷性小, 是正確指導臨床醫生選擇合理治療方法的一種較好的輔助檢查技術。
Objective To compare the short- and long-term survival of patients with stage T1N0M0 non-small cell lung cancer (NSCLC) undergoing robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS). Methods The clinical data of 396 patients with stage T1N0M0 NSCLC treated with RATS or VATS in our hospital from 2012 to 2019 were retrospectively analyzed. There were 209 males and 187 females, with a mean age of 61.58±8.67 years. According to surgical procedures, they were separated into two groups: a RATS group (n=157) and a VATS group (n=239). The two groups were compared in terms of the survival and prognosis-influencing factors. Results The intraoperative blood loss and postoperative 24 h drainage volume in the RATS group were less than those in the VATS group (48±42 mL vs. 182±231 mL, P<0.001; 250±119 mL vs. 324±208 mL, P<0.001). The groups and number of dissected lymph node in the RATS group were more than those of the VATS group (5±2 groups vs. 3±2 groups, P<0.001; 17±9 vs. 11±8, P<0.001). There was no statistical difference in the postoperative 48 h drainage volume (P=0.497), postoperative intubation time (P=0.180) or hospital stay (P=0.313). The survival state and recurrence-free survival state in the VATS group were better than those in the VATS group (1-year survival rate: 98.7% vs. 94.8%, 5-year survival rate: 90.5% vs. 75.8%, 8-year survival rate: 76.9% vs. 62.1%, mean survival time: 93 months vs. 79 months, P=0.005; 1-year recurrence-free survival rate: 97.4% vs. 95.6%, 5-year recurrence-free survival rate: 94.8% vs. 77.8%, 8-year recurrence-free survival rate: 82.6% vs. 64.8%, mean recurrence-free survival time: 95 months vs. 79 months, P=0.004). Univariate analysis showed that surgical method, the groups and the number of dissected lymph nodes were the influencing factors for postoperative overall survival and recurrence-free survival. At the same time, the results of multivariate analysis showed that surgical method was a common independent factor for overall survival and recurrence-free survival.Conclusion RATS can obtain better survival in patients with T1N0M0 NSCLC, and RATS has more thorough lymph node dissection, less intraoperative blood loss and postoperative 24 h drainage volume.
ObjectiveTo retrospectively investigate the drug use of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011, and to compare with outpatients with lung cancer concurrently, so as to evaluate the rationality of drug use among over-60-year inpatients with lung cancer in the West China Hospital. MethodsThe information of over-60-year inpatients with lung cancer as initial diagnosis in the West China Hospital in 2011 was collected from the hospital information system (HIS), including patient information, drug use information, cost information, etc. Data rearrangement and analysis by classes and costs were carried out using Microsoft Excel 2010 software. Resultsa) There was 2 215 person-times of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011. A total of 5 classes, 63 kinds of anti-tumor and adjuvant therapy drugs were involved. The total drug use frequency was 12 398 person-times. The average medicine cost was 774.93 yuan. b) The ratio of patients using 1 to 4 kinds of drugs was 34.31%, 5 to 10 kinds was 41.9%, and 11 to 15 kinds was 12.63%. c) For etiological treatment, the ratio of chemotherapy drugs was 99.45%, and the most used was cisplatin. d) For symptomatic treatment, the ratio of analgesics was 66.69%; the ratio of antitussive drugs was 21.33%; and the ratio of skeletal related events prevention drugs was 11.98%. e) For anti-ADR treatment, the ratio of antiemetic drugs was 55.07%; the ratio of stomach protection drugs was 32.63%; and the ratio of hepatic protection drugs was 12.30%. f) For other treatment, the ratio of immunopotentiating drugs was 59.46%; and the ratio of hematopoietic growth factor was 25.42%. g) For Chinese patent medicine, drugs used over 400 person-times were Diyushengbai tablet, Javanica oil emulsion injection, Aidi injection, and Huisheng oral liquid. h) For single/combined treatment, the ratio of two-drug combined chemotherapy was 78.38%, one analgesics drug treatment was 66.21%, one hepatic protection drug treatment was 83.41%, two-drug combined antanacathartic treatment was 45.88%, one stomach protection drug treatment was 90.53%, one immunopotentiating drug treatment was 90.53%, one hematopoietic growth factor treatment was 82.31%, and one Chinese patent medicine treatment was 37.39%, respectively; and antitussive and skeletal related events prevention drugs were used alone. i) The use frequency of the top 10 drugs were: pantoprazole, tropisetron, ondansetron, diphenhydramine, thymopentin, cisplatin, Diyushengbai tablet, tramadol, Javanica oil emulsion injection, and Aidi injection. j) Compared with outpatients, inpatients drug use frequency was higher in chemotherapy, analgesics, antiemetic, stomach protection, hepatic protection drugs, and Chinese patent medicine; but lower in skeletal related events prevention drug; and similar to the drug use situation of outpatients in immunopotentiating drugs and hematopoietic growth factor drugs. ConclusionThe antitumor therapies were mainly the combination of two chemotherapy drugs or single drug regimen for over-60-year inpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antiemetic and stomach protection drugs. Chinese patent medicine and immunopotentiating drugs are in common use as well.
Lung microbiome is defined as the specific microbiota of lung. Lung microbiome can make the lung in a state of chronic inflammation through direct destruction, activation of inflammatory cells and release of inflammatory factors, and then progress to lung cancer. There are significant differences in lung microbiome between lung cancer patients and healthy people. Some specific microbial flora can be used as a diagnostic marker of lung cancer. Specific microbial communities are related to the efficacy of immunotherapy, and microbial composition may be used as a marker of immune-related adverse events. There are both challenges and opportunities for research on the relationship between lung microbiome and lung cancer. This review will focus on the significance and value of lung microbiome in the occurrence, diagnosis and immunotherapy of lung cancer, in order to provide a reference for basic and clinical researchers in related fields.
Objective To detect the difference of periostin expression in small cell lung cancer (SCLC) cell, and explore its effect on chemoresistance of SCLC patients. Methods The expression of periostin in mRNA and protein was detected by RT-PCR and Western blot analysis in SCLC H69 and multidrug resistant strain H69AR. The expression of periostin was up-regulated by recombinant plasmid-periostin in H69 cell. The survival rate in the transfected group was different from that of the negative control group and uninterrupted group. Results The expression of periostin mRNA and protein in the sensitive strain H69 was lower than that of the multidrug resistant strain H69AR (P<0.05). The recombinant periostin-plasmid was transfected into H69 cells and at the same concentration of chemotherapeutic drugs (cisplatin, etoposide) the survival rate increased significantly (P<0.05). The positive expression rate of periostin in SCLC tissues was 67.44%, and the sensitivity of the chemotherapy group was lower than that of the drug resistant group (P<0.05). Conclusion The expression of periostin in SCLC cell H69 is significantly lower than that of the multidrug resistant strain H69AR and overexpression of periostin increases resistance of the sensitive strain H69 and hence periostin may be involved in SCLC chemoresistance.